In a far-reaching super-session on adverse childhood experiences (ACEs), four experts from different fields discussed the current state of research on ACEs and policies aimed at mitigating their effects on children, adults, and families. Soledad de Gregorio from Abt Associates began the session with a comprehensive overview of the types of experiences that fall into the ACEs definition, as well as some important context-setting statistics. Adverse childhood experiences include directly experiencing or witnessing violence, abuse, neglect, isolation, hunger, and several other experiences. More than half of all adults report one or more ACE. Research shows that these experiences are linked with many negative short- and long-term life outcomes including in the areas of health, education, and employment.
Each panelist approached ACEs and what can be done to reduce their impact from a different disciplinary and life-course perspective. April Joy Damian from the Weitzman Institute studies the whole life-course to understand how both children and older adults experience ACEs. She highlighted the importance of focusing on those with elevated levels of ACEs including women, people of color, people living in persistent poverty, and those that identify as LGBTQ . In an especially moving comment, April Joy shared that many older adults have never been asked about their negative childhood experiences, a testament to the importance of her work.
Anne Fletcher from the U.S. Department of Housing and Urban Development emphasized that safe, stable, and affordable housing is critical for family wellbeing. Through a large-scale randomized control trial, Fletcher and other researchers at HUD identified the benefits of long-term housing subsidies on children and families, including a reduction in exposure to ACEs.
Finally, Cori Sheedy shared her perspective as an Abt Associate researcher and her focus on behavioral and health equity among children. Through research on Medicaid and the Children’s Health Insurance Program, Cori helps identify and support strategies to improve screening and protection against ACEs through health care systems and other agencies.
The panelists shared several concrete policy recommendations.
On the housing side, we need to increase the supply and access to housing programs. Just 25% of families that qualify for HUD housing vouchers receive benefits because of other structural barriers, despite concrete evidence that the vouchers effectively protect children against ACEs.
In terms of identifying ACEs early in a child’s life and intervening quickly, health advocates should work to normalize conversations between pediatricians and caregivers about ACEs. This is especially true in the wake of COVID-19 where the potential for ACEs concentrated among children who were tied to adverse family situations. Funding community after school and food assistance programs and mental health services can also mitigate these impacts.
Finally, each speaker reiterated the importance of interdisciplinary research to understand ACEs, and cross-system collaboration among policymakers to address their impacts. By coordinating efforts to study and address ACEs, we can push back against the current model that multiple panelists voiced where “children do not develop in isolation, systems do”.